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Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the effects of TC on pain and functional disability in CNS-LBP patients aged 50 years old or above. Forty-three individuals (aged 50 years old or above) with CNS-LBP were randomly assigned into three groups: Chen-Style TC group (n = 15), Core Stabilization training (CST) group (n = 15), and control group (n = 13). Participants in the TC group participated in Chen-style TC training program (three 60-min sessions per week for 12 weeks), individuals in CST group received 12-week Core Stabilization exercise on the Swiss ball, whereas individuals in the control group maintained their unaltered lifestyle. Pain intensity as primary outcome was measured using the Visual Analogue Scale (VAS), A BiodexSystem 3 isokinetic dynamometer was used to measure knee and ankle joint position sense (JPS) as secondary outcomes at baseline and after the 12-week intervention. TC and CST have significant effects in VAS for CNS-LBP patients (p< 0.01, TC group OR CST group versus control group in mean of the post-minus-pre assessment). However, the feature of joint position sense (JPS) of ankle inversion, ankle eversion and knee flexion did not occur, it showed no significant effects with TC and CST. TC was found to reduce pain, but not improve lower limb proprioception in patients with CNS-LBP. Future research with larger sample sizes will be needed to achieve more definitive findings on the effects of TC on both pain and lower limb proprioception in this population.

Self myofascial therapy via foam roller is a common technique used by many athletes and patients to aid recovery, improve range of motion (ROM) and prevent injury. Further, it is suggested that foam rolling improves core stability. However, research about the training effects of foam rolling on measures of core \"strength endurance\", muscle performance, balance and flexibility is limited. Forty recreationally active females and males (age: 18-48 yrs) were randomly assigned to a foam roll (FOAM, n = 14), a core stabilization (CORE; n = 12) and a control group (CG, n = 12). FOAM massaged their lower leg muscles (5 exercises) with the foam roll 2 times per week for 8 weeks while CORE was assigned to core stability training including 5 exercises. CG underwent no intervention. Applied tests for outcome measurements were the Bourban trunk muscle strength test (TMS), standing long jump (SLJ), single leg triple hop for distance (SLTH) test, Y-Balance test and stand and reach test. There was an interaction effect (time x treatment) for the dorsal TMS (p = 0.043), demonstrating greater improvements in CORE compared with FOAM and CG with no difference between FOAM and CG. For the stand and reach test a main effect for time (p < 0.001) and time x treatment interaction (p = 0.005) were found, indicating an increase in ROM in FOAM compared with CORE and CG with no difference between the latter. No significant effects were found for balance and muscle performance. An 8-week training with the foam roll is effective in increasing ROM in the stand and reach test without concomitant decreases in core \"strength endurance\", muscle performance and balance parameters. The core stabilization training was sufficient to improve performance in dorsal TMS test.

Introduction: Appropriate exercise therapies are still being investigated for primary knee osteoarthritis, which greatly contributes to chronic pain and functional impairment in older adults. Objective: The purpose of this study was to evaluate the effectiveness of adding core stability to biofeedback-assisted quadriceps-hamstring strengthening for individuals with primary osteoarthritis of the knee. Methodology: Participants between the ages of 50 and 65 participated in a parallel-group, randomised controlled study conducted at a single location. For six weeks, participants participated in twice-weekly supervised exercise sessions. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess functional status at baseline and on a weekly basis, while the Numeric Rating Scale was used to measure the intensity of pain. Results: Forty participants were randomized, with 39 completing the study. Both groups shown gradual enhancements in pain and functionality. Significant between-group differences in pain emerged from week four, and by week six, the combined intervention group showed lower pain levels compared to the strengthening-only group. Functional outcomes also showed significant differences at week six, favoring the combined intervention. Statistical analysis revealed significant time-by-group interactions for both pain and functional measures. Discussion: The addition of core stabilization appears to enhance the effectiveness of strengthening exercises, possibly by improving neuromuscular control and joint stability. Conclusions: Incorporating core stabilization into strengthening programs provides additional short-term benefits in reducing pain and improving function in individuals with primary knee osteoarthritis. Introdução: A osteoartrite primária da rodilla é um fator importante na geração de dor crónica e limitações funcionais nas pessoas mais velhas, e continua a investigar as melhores estratégias de exercício. Objectivo: Avaliar a eficácia da adição de estabilização do core ao fortalecimento cuádriceps-isquiotibiales guiado por biofeedback em doentes com osteoartrite primária de rodilla. Metodologia: Foi realizado um ensaio controlado randomizado de grupos paralelos num único centro, com participantes dos 50 aos 65 anos. Os sujeitos realizaram sessões de exercício supervisionadas duas vezes por semana, durante seis semanas. Se utilizou a Escala Numérica para levar a cabo a avaliação da intensidade da dor, enquanto a função foi determinada usando o índice WOMAC tanto no início como semanalmente. Resultados: Foram aleatorizados 40 participantes, dos quais 39 completaram o estúdio. Ambos os grupos apresentam melhorias progressivas na dor e na função. As diferenças entre grupos de dor surgiram desde a quarta semana, sendo que na sexta semana o grupo com intervenção combinada apresentou níveis de dor mais baixos. Os resultados funcionais também mostram diferenças importantes a favor do grupo combinado. A análise estadística mostrou interações importantes ao longo do tempo em grupo. Discussão: A inclusão da estabilização do core melhora a eficácia do fortalecimento, possivelmente através de uma melhoria do controlo neuromuscular e da estabilidade articular. Conclusões: A estabilização do core, quando integrada, proporciona benefícios adicionais na redução da dor e na melhoria da função em doentes que sofrem de osteoartrite primária de rodilla. Introducción: La osteoartritis primaria de rodilla es un factor importante en la generación de dolor crónico y limitaciones funcionales en las personas mayores, y se sigue investigando sobre las mejores estrategias de ejercicio. Objetivo: Evaluar la eficacia de añadir estabilización del core al fortalecimiento de cuádriceps–isquiotibiales guiado por biofeedback en pacientes con osteoartritis primaria de rodilla. Metodología: Se realizó un ensayo controlado aleatorizado de grupos paralelos en un solo centro, con participantes de 50 a 65 años. Los sujetos realizaron sesiones de ejercicio supervisado dos veces por semana durante seis semanas. Se utilizó la Escala Numérica para llevar a cabo la evaluación de la intensidad del dolor, mientras que la función se determinó utilizando el índice WOMAC tanto al inicio como semanalmente. Resultados: Se aleatorizaron 40 participantes, de los cuales 39 completaron el estudio. Ambos grupos mostraron mejoras progresivas en dolor y función. Las diferencias entre grupos en dolor aparecieron desde la cuarta semana, y en la sexta semana el grupo con intervención combinada presentó menores niveles de dolor. Los resultados funcionales también mostraron diferencias significativas a favor del grupo combinado. El análisis estadístico mostró interacciones significativas tiempo por grupo. Discusión: La inclusión de estabilización del core mejora la eficacia del fortalecimiento, posiblemente mediante una mejoría en el control neuromuscular y la estabilidad articular. Conclusiones: La estabilización del core, cuando se integra, proporciona beneficios adicionales en la reducción del dolor y la mejora de la función en pacientes que padecen osteoartritis primaria de rodilla.

To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP). A total of forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment. It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05). The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly. NCT03898089.

Background Primary osteoporosis refers to a disease of aging characterized by reduced bone mass, damage to bone tissue microarchitecture, and predisposition to fracture.Sling core stabilization training emphasizes activating the deep local muscles of the spine under unstable conditions, and enhancing the body’s balance and control during exercise. Case presentation A 70-year-old female went to the Acupuncture and Rehabilitation Department due to low back pain caused by osteoporosis.The patient received sling core stabilization training three times a week based on Calcium and Vitamin D Supplementation. After training, the patient’s back pain was significantly relieved and insisted one year. In the physical examination of bone mineral density, the results showed that the value of bone mineral density was better than last year.The patients adhered to sling core stabilization training and observed the changes of bone mineral density every year basis on calcium and vitamin D supplementation. Discussion However, cases of calcium and vitamin D supplementation-based regular sling core stabilization training that improves bone density in osteoporosis patients have been rarely reported. Our group shared cases and analyzed possible mechanisms, hoping to provide reference for the prevention and treatment of primary osteoporosis.

Background Chronic non-specific low back pain (CNSLBP) is often associated with morphological changes in the lumbar multifidus muscle (LMF), such as reduced cross-sectional area (CSA) and increased fat infiltration, compromising spinal stability and function. Core stabilization exercises aim to enhance neuromuscular control by targeting deep trunk muscles. However, few randomized trials have investigated their effects on MRI-based muscle morphology and clinical outcomes. This study aimed to compare the effects of an 8-week core stabilization exercise program versus conventional physiotherapy on LMF morphology, pain intensity, disability, and core stability in individuals with CNSLBP. Methods In this two-arm, parallel-group randomized controlled trial, 36 individuals with CNSLBP (> 3 months) were randomized to a Core Exercise Group (CEG, n  = 18) or a Conventional Physiotherapy Group (CPG, n  = 18). The 8-week intervention included a 4-week supervised clinical phase and a 4-week home-based phase. The primary outcome was the CSA of the LMF, as this parameter was used for the sample size calculation. Secondary outcomes included LMF fat infiltration (Goutallier grade), pain intensity (visual analog scale), functional disability (Oswestry Disability Index), and core stability (Sahrmann test). Assessments were conducted at baseline and post-intervention. We analyzed within-group change, between-group differences, and group × time interactions using mixed ANOVA; when assumptions were violated, we used non-parametric alternatives (including ART ANOVA). Effect sizes were reported. Results Thirty-one participants completed the trial (CEG, n  = 15; CPG, n  = 16). Both groups showed significant improvements in clinical and functional outcomes ( p  < 0.05). The CEG additionally demonstrated greater CSA increases—especially at L3–L5 levels ( p  < 0.01)—and more notable reductions in fat infiltration ( p  < 0.05). Activity-related pain decreased by 4.4 points in the CEG versus 1.8 points in the CPG ( p  < 0.001). Functional disability improved by 31 points in the CEG compared to 10 points in the CPG ( p  < 0.001). Core stability increased to a median Sahrmann test level of 4 in the CEG versus 3 in the CPG ( p  < 0.001). Conclusions Core stabilization exercises yielded superior improvements in LMF morphology, pain relief, functional recovery, and trunk control compared to conventional physiotherapy in individuals with CNSLBP. These findings support the integration of core-focused rehabilitation strategies into standard clinical practice for CNSLBP. Trial registration ClinicalTrials.gov Identifier: NCT05302349, protocol ID: 2022–695, registered on March 21, 2022.

Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities, appearing far into puberty. Schroth’s exercises (SE) and core-stabilization exercises (CE) have become very prominent among the specialized and general methods to scoliosis treatment. However, their effects are still unclear and there is insufficient evidence of superiority between them. Therefore, we aimed to evaluate and compare the effectiveness of these methods on Cobb angles (CA) in AIS. Methods: A systematic review was performed on SE and CE papers. The databases included PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar from January 2005 to June 2022. The physiotherapy evidence database (PEDro) scale assessed the quality and provided internal validity and the statistical information of the papers. Results: After screening 410 papers, nine papers (SE=5, CE=3 and SE vs. CE=1), with 339 participants, were admitted for review (PEDro=6). Among them, three (SE=moderate evidence) and two papers (CE=limited evidence) reported clinically significant reductions in CA>5˚, alone or compared to control or other exercise methods, while only one paper (very limited evidence) showed the relative superiority of SE (-7.16˚) compared to CE (-3.27˚). However, three papers did not show clinically significant results (CA<5˚). Conclusion: Moderate and limited evidence suggests that both SE and CE can effectively improve CA, respectively. There is very limited evidence to suggest that SE is more effective than CE in treating AIS. Thus, the definitive answers to the questions, especially concerning the superiority between these two methods, remained unclear. Further high-quality studies must be conducted in the future.

Background Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities. Core stabilization exercise (CSE) has become a common approach in the treatment of AIS. However, the efficacy of CSE in AIS remains a subject of debate. Objective To determine the efficacy of CSE in the patients with AIS in comparison with different intervention programs. Methods A comprehensive search was conducted across PubMed, Embase, The Cochrane Library, Web of Science, Wan Fang, Wei Pu, and CNKI databases, encompassing literature from their inception through December 31st, 2024. Two independent reviewers screened the studies, with inter-rater agreement evaluated via kappa scores. Randomized control trials that focus on the efficacy and safety of CSE in AIS population were included in this systematic review. The risk of bias assessment was performed utilizing the National Institutes of Health Quality Assessment Tools (NIH-QAT). After quality assessments and information extraction, the meta-analysis was conducted with Review manager and the standard mean difference (SMD) was pooled among the measurement data derived from different studies. Cobb angle, angle of trunk rotation, apical vertebral rotation, Walter Reed Visual Assessment Scale, Posterior Trunk Symmetry Index, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, SRS-22,, were focused as outcomes. Results A total of 10 studies involving 449 subjects were included in this systematic review. The average Cobb angle was 22.86° ± 8.79°, and the intervention duration varied from 8weeks to 6months. The kappa score was 0.93. Subgroup analyses were performed based on the different control groups, National Institutes of Health Quality Assessment Tools (NIH-QAT) results, and intervention durations. The results indicated that CSE could have greater effect sizes than the blank control group on Cobb angle (MD = -4.37, P  < 0.05), angle of trunk rotation (MD = -1.07, P  < 0.05), apical vertebral rotation (MD = -0.44, P  < 0.05), quality of life as SRS-22 (MD = 0.22, P  < 0.05). Notably, the efficacy of CSE appears to be weaker than that of the three-dimensional exercise group in terms of Cobb angle (MD = 3.95, P  < 0.05), angle of trunk rotation (MD = 1.69, P  < 0.05) and WASRS scores (MD = 0.89, P  < 0.05). Other subgroup analyses yielded no statistically significant differences. Conclusions The present study showed that core stabilization exercise may be beneficial for the patients with mild to moderate adolescent idiopathic scoliosis, albeit less effective than three-dimensional exercises following short-term follow-up. The evidence on the efficacy of CSE is limited due to heterogeneity, small sample sizes, and multiple comparisons. The clinical trials focusing on patient compliance and training quality with long-term follow-up are warranted. PROSPERO registration number CRD 42022367714.

Background Stroke is a major cause of disability with mainly affecting trunk mobility and function. The purpose of this study is to determine the effectiveness of core stabilization exercises versus conventional therapy on trunk mobility, function, ambulation, and quality of life of stroke patients. Design Assessor blinded randomized control trial. Setting Ibrahim polyclinic—Shadman, Ch Muhammad Akram teaching hospital-Raiwind, Rasheed hospital-Defence. Subjects Chronic ischemic stroke patients. Intervention Control group (n = 21) underwent conventional treatment for stroke for 40 min/ day, 5 times/ week for 8 weeks. Experimental group (n = 20) received core stability training for additional 15 min along with conventional treatment. Main measures Main outcome measures were Trunk impairment scale (TIS), functional ambulation category (FAC), stroke specific quality of life (SSQOL) and trunk range of motion (ROM). Results The differences between the control group and experimental group post-treatment were statistically significant for trunk impairment, functional ambulation, quality of life, and frontal plane trunk motion (p-value < 0.05) with higher mean values for core stabilization training. The frontal plane trunk mobility and rotation showed non-significant differences post-treatment (p-value > 0.05). Conclusion This study concluded that core stabilization training is better as compared to the conventional physical therapy treatment for improving trunk impairments, functional ambulation and quality of life among patients of stroke. The core stabilization training is also more effective in improving trunk mobility in sagittal plane. This study is registered in Iranian Registry of Clinical Trials IRCT20210614051578N1 and was approved by the local research ethics committee of Riphah International University.

Background and objectives: Although different variations of the Pallof press exercise are commonly performed in sports and fitness settings to increase core stability, the intensity/difficulty of these variations is unknown and therefore it is difficult to control the training load and establish exercise progressions. This study aimed to compare and rank the postural control challenge imposed by five different isometric variations of the Pallof press exercise through a smartphone accelerometer placed on the participants’ pelvis and to explore sex differences in the lumbopelvic postural control during the exercise performance. Materials and Methods: Twelve physically active participants completed two testing sessions in which they performed two sets of five different isometric variations of the Pallof press exercise (changing the body position and/or the support surface: kneeling on a foam pad, feet together standing on the floor, tandem stance on the floor, feet together standing on a hemisphere ball, and tandem stance on a hemisphere ball). After confirming the acceleration data reliability (intraclass correlation coefficients ≥ 0.72 and typical errors ≤ 17%), a repeated measure ANOVA was carried out to classify the Pallof press variations according to the postural control challenge imposed on the participants and to analyze sex differences on postural control. Results: Significant effects were found for the within-subject factor exercise variations but not for the between-subject factor sex. Pairwise comparisons showed that the exercise variations performed on the hemisphere ball (feet together standing: 0.55 m/s2; tandem stance: 0.61 m/s2) imposed higher postural control demands than those performed on the other surfaces (kneeling on a foam pad: 0.17 m/s2; feet together standing on the floor: 0.22 m/s2; tandem stance on the floor: 0.31 m/s2). In addition, the tandem stance on the floor produced higher lumbopelvic accelerations than the Pallof press kneeling variation. Conclusions: The Pallof press performance in standing rather than kneeling (i.e., reducing the base of support and raising the center of gravity and the height of the lateral force applied by the elastic band) and on a hemisphere ball increased the exercise difficulty compared to more stable surfaces. This information could help to modulate the difficulty and establish progressions for this exercise in physically active young males and females.